Premium
Poster Abstracts
Author(s) -
Peter, John Victor,
Thomas, Lovely,
Graham, Petra,
Moran, John,
Abhilash, K. P,
Jasmine, Sudha,
Iyyadurai, Ramya
Publication year - 2013
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12150
Subject(s) - medicine
Background: Clinical scoring systems are used to predict outcome in hospitalized patients. Aims/Objectives:The utility of scoring systems in acute organophosphate poisoning was explored. Methods: In this retrospective study of 396 patients admitted with organophosphate poisoning over a 6-year period, we evaluated the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the Simplified Acute Physiology Score (SAPS) II, Mortality Prediction Model (MPM) II and the Poisoning Severity Score (PSS). Demographic, laboratory and survival data were recorded. Receiver operating characteristic (ROC) curves were generated and the area under the curve (AUC) calculated to study the relationship between individual scores and mortality. Results: The mean (standard deviation) age was 31.4 (12.7) years and admission pseudocholinesterase (median, interquartile) level 317 (222–635) U/L (Reference range 3000–6000 U/L) Mechanical ventilation was required in 65.7%. Overall mortality was 13.1%. The mean (95% Confidence Interval) scores were 16.4 (15.5–17.3) for APACHE-II, 34.4 (32.5–36.2) for SAPS-II, 28.6 (25.7–31.5) for MPM-II and 2.4 (2.3–2.5) for PSS. Overall, the AUC was higher for APACHE-II (0.77), SAPS-II (0.77) and MPM-II (0.75) than for the PSS (0.67). When patients were categorized based on the World Health Organization (WHO) hazard class, although APACHE-II performed the best, its performance as assessed by the AUC was better for WHO Class II (0.82) than Class I compounds (0.63). For individual compounds, the AUC for APACHE-II was highest for quinalphos (0.93, n = 46) and chlorpyrifos (0.86, n = 38) and lowest for monocrotophos (0.60, n = 63). Across the WHO categories and for individual compounds, the AUCs for SAPS-II and MPM-II were only marginally lower than that of the AUCs for APACHE-II. The performance of the PSS was poor across all categories. Conclusions: Of the commonly used scoring systems, APACHE-II appears to perform best in the setting of acute organophosphate poisoning.1 page(s